The Food and Drug Administration (FDA) said it is reviewing the safety of birth control pills because of clotting concerns.
Although all hormonal birth control pills raise the risk of clots, the FDA's review focuses on those containing the hormone drospirenone. The agency cites two studies, published in April in BMJ, that found that women aged 15-44 taking drospirenone-containing birth control pills were two to three times more likely to develop venous thromboembolism — blood clots that develop in the deep veins of the legs — than women using older pills containing the progestin levonorgestrel.
European regulators said last week that they would revise prescribing information for relevant products to include the new findings. The FDA is investigating whether or not to do the same, but the agency remains cautious because past data contradict the newest research.
Nicola Goss, 35, collapsed suddenly after complaining of stomach cramps and sickness after a blood clot developed in her bloodstream.
Nicola, who had been taking the pill for seven years, was fit and healthy and had rarely seen her doctor apart from at regular check ups.
Rob Dugay, her partner of six years, said: 'The coroner has said the pill may have played a part in causing the clot. I can't believe that something that's such a part of every day life could have caused her death.'
As little as 1 in 300 women per year who are taking birth control pills may developing a blod clot. For women with thrombophilia, hypercoagulability or prothrombotic states, this risk is significantly higher.
The new patches (transdermal contraceptives) may increase this risk even more. The amount of estrogen absorbed from the patches has been reported to be 60 percent higher than the amount delivered by the pills. Little information about the risk of blood clots with birth control rings is available. Like patches and most birth control pills, these devices also contain an estrogen and a progestin; thus they probably carry a risk of thrombosis similar to that of birth control pills or patches.
A study from Belgium showed that long-term use of oral contraceptives — at least the high-estrogen ones sold decades ago — might increase the chances of having artery buildups that can raise the risk of heart disease.
Other research confirmed that the main ingredient in the contraceptive shots -- depo medroxyprogesterone acetate or DMPA -- can cause significant bone loss when used long term. And, say experts, the younger you are when you begin using this contraceptive, the greater your risk of bone-related problems later in life.
In 2005, Johnson and Johnson subsidiary Ortho McNeil, makers of Ortho Evra, issued a warning saying women using the patch will be exposed to about 60% more estrogen than those using typical birth-control pills because hormones from patches get into the bloodstream and are removed from the body differently than those from pills.
If you're going the natural route for birth control, you'll probably be better off combining two methods rather than depending on only one, suggests health expert Dr. Weil.
For example, the cervical mucus method can be 98 percent effective when used in conjunction with the temperature method.
- Cervical mucus: This involves checking the amount and texture of your cervical mucus, a vaginal discharge that reflects estrogen levels at various points in the menstrual cycle. Just after menstruation you probably won't notice any cervical mucus at all. Later, you'll see a cloudy, sticky mucus. When this increases in volume and resembles raw egg white, ovulation is near. As soon as you notice this change, be sure to avoid intercourse until four days after you observe that the mucus is again cloudy and sticky or has disappeared altogether.
- Temperature: This approach involves taking your temperature with a special "basal" thermometer as soon as you wake up in the morning. Your normal temperature probably will range from 97.2 to 97.7 degrees before ovulation. The hormonal changes prior to ovulation boost basal body temperature; you'll see an increase of 0.5 to 1.6 degrees. When your temperature is elevated for at least two days, you'll know you are ovulating and should avoid intercourse. You can resume having sex when your temperature returns to normal.
- Calendar Method: If your menstrual cycle is very regular, you could try the "calendar" method, which involves avoiding sex during the week that you believe you're ovulating. To do this right you'll have to first track your periods for a year. Then to figure out when you might be fertile, subtract 18 from the number of days of your shortest cycle in the past year. This is the date on which you should stop having sex. To calculate when you can resume, subtract 10 from the number of days in your shortest cycle. Used on its own, the calendar method has a 75 percent success rate.
- Withdrawal: This method requires the man to withdraw his penis from the vagina before ejaculation. This is the least reliable of the natural methods: only 60 to 80 percent successful.
You also have the option of using a diaphragm or condoms. Used consistently, diaphragms are 84 percent effective when used in conjunction with a spermicidal cream; condoms are 97 percent effective when used consistently and correctly and have the added advantage of protecting against sexually transmitted diseases.
Bottom Line: Birth control pills should be your last choice of contraception. For hormonal stability, long-term health and disease prevention, avoid the pill whenever possible.